MedicaidPrior AuthLow impact
Loqtorzi™ (toripalimab-tpzi) (New)
Humana·LA · Oncology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Loqtorzi (toripalimab-tpzi), an immunotherapy drug for nasopharyngeal carcinoma. Prior authorization will be required starting February 1, 2026, with specific criteria for metastatic or recurrent locally advanced NPC treatment.
Action Required
By February 1, 2026: Billing team must update prior authorization procedures for Loqtorzi (toripalimab-tpzi) for Louisiana Medicaid patients with nasopharyngeal carcinoma. Ensure providers document diagnosis of metastatic or recurrent locally advanced NPC and treatment setting (first-line with cisplatin/gemcitabine or single agent after platinum progression). Verify patients have not progressed on prior PD-1/PD-L1 inhibitors. Obtain prior authorization through www.humana.com/PAL before treatment initiation.